Prenatal antipsychotic exposure linked to reduced neuromotor performance

By Mark Cowen, Senior MedWire Reporter

Infants with prenatal exposure to antipsychotics show significant reductions in neuromotor performance compared with other children, US researchers report.

However, "future investigations are warranted to disentangle the relative contribution of antipsychotic medications, maternal mental illness, concomitant medications, and the broader psychosocial context in the developmental trajectory of high-risk infants," comment Katrina Johnson (Emory University, Atlanta, Georgia) and colleagues.

The team used the Infant Neurological International Battery (INFANIB) to compare neuromotor performance among 22 infants with prenatal exposure to antipsychotics, 202 with prenatal exposure to antidepressants, and 85 infants with no prenatal exposure to such medications. All of the children were aged 6 months at the time of testing.

The infants were also compared for habituation using a test involving repeated viewing of a neutral female face.

The researchers found that INFANIB scores were significantly associated with a maternal history of depression and psychosis, and with overall maternal illness severity.

After adjustment for these variables, as well as for maternal age and marital status, analysis showed that infants with prenatal antipsychotic exposure had significantly lower mean INFANIB scores (63.86) than those with prenatal antidepressant exposure (68.58) and those without such prenatal medication exposure (70.12).

The difference in INFANIB scores between antidepressant-exposed infants and nonexposed infants was not significant.

There were also no significant differences regarding habituation between the three groups of infants.

"In summary, these data suggest that prenatal antipsychotic exposure may influence infant neuromotor performance at 6 months of age," write Johnson et al in the Archives of General Psychiatry.

They add that the findings "support an additional level of clinical scrutiny in medication selection, treatment planning, and risk/benefit discussions for women with illnesses who may warrant antipsychotic pharmacotherapy during gestation."

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